All you need to know about blood pressure

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Your heart is a hard working muscle which works like a pump to send blood around your body through a complex network of arteries and capillaries and back via your veins.

A lot of force is required with each contraction of the heart muscle (or heart beat) to pump the blood out of your heart, through your lungs where it picks up oxygen and all round your body. A single blood cell can do a full journey through your body, from your heart and back in about 45 seconds, although this might take 50 or 60 beats of your heart.

As blood is pumped through the arteries they stretch a little to accommodate the flow of blood. Your blood pressure is the force of this blood in your body pushing against the walls of your arteries as your heart is pumping.

Why do we need blood pressure?

Blood pressure is vital to your circulation.

Your blood needs to move around the whole of your body and reach every part of it, but especially your brain.Your brain needs 750ml of oxygenated blood a minute, 24 hours a day whatever you are doing. If you don’t get enough blood to your brain you feel faint. If your heart stops beating (as in a cardiac arrest) your blood pressure drops to zero and your brain receives no blood at all – this can cause lasting brain damage or death within a few minutes.

Most people with high blood pressure can exercise safely and are advised to do so as long as they don’t overdo it.

Exercise can help reduce your blood pressure although it’s not clear exactly how it works. Exercise-induced blood pressure changes may be partly due to the weight you lose when you exercise regularly.

But in any case, for an overall boost to your health, reduction in stress and to help your heart and circulation there is nothing to beat it.

You should select moderate aerobic activity and build up gradually from just a few minutes if you are unused to exercise. You will be amazed at how quickly your stamina improves if you make the initial effort and then keep at it.

To be on the safe side check any exercise program you plan on following out with your doctor and avoid competitive or vigorous exercise such as running a marathon or squash.

Stick to moderate aerobic exercise rather than exercises which cause you to strain such as weight training or muscle building isometric type exercises, which can actually cause blood pressure to rise.

You will notice that your blood pressure is checked at every ante natal appointment during pregnancy.

Blood pressure is not usually raised during the first 20 weeks of pregnancy and may be lower than usual.

If you get a high blood pressure reading it may be because your blood pressure was already high before you became pregnant. If it is only mildly raised you will probably be advised to make lifestyle changes, with medication only being prescribed for more serious cases.

If your blood pressure is very high you may need to be admitted for tests in hospital to check if you have a problem such as diabetes or a kidney disorder and your baby will be monitored to ensure that he or she is growing properly.

After 20 weeks of pregnancy, blood pressure normally drops as the blood vessels dilate due to the action of hormones released in pregnancy and the placenta pumps blood to the baby. Sometimes low blood pressure in pregnancy can cause fainting and dizziness.

In later pregnancy (after 28 weeks) high blood pressure can be a sign of pre-eclampsia – which 1 in 4 women experience with a first baby (it is less common in later pregnancies).

If left untreated, eclampsia can develop and this is dangerous to the lives of both mother and child. Other symptoms of pre-eclampsia are swelling in the ankles, hands or feet,sudden weight gain and protein in the urine. If you have this you will be admitted to hospital for monitoring and may need to give birth early if blood pressure continues to rise or your baby’s growth is affected.

Usually high blood pressure due to eclampsia comes back down after the birth of the child and no further treatment is necessary although you may be more likely to suffer high blood pressure later in life and should ask to be checked regularly.

Stress and anxiety make your heart beat harder and push up your blood pressure at least in the short term due to the release of the hormone narrowing your blood vessels.

That is how the “white coat” effect comes about – you get raised blood pressure because you are anxious having your blood pressure taken!

But there is conflicting medical evidence about whether anxiety or stress cause permanent high blood pressure.

If you have chronic anxiety and have persistently raised blood pressure as a result some damage may be done to your arteries but it would be rare for anyone to live in a constant state of anxiety or stress. You are not stressed or anxious when asleep for example even if you are highly anxious all the time you are awake.

So why is stress so closely linked to high blood pressure in the media and popular medical press?

It may be because stressful or anxiety producing situations can temporarily raise your blood pressure and if you already have high blood pressure then that can be dangerous.

Even if it is not 100% certain whether normal stress has a long term harmful effect on your blood pressure, it makes sense to take life more calmly.

A study of 300 men in the US found that those reporting high levels of stress had blood pressure which was raised by the equivalent of 20 years in age.

Researchers have also found that those who feel less in control of their lives have a tendency to experience higher blood pressure than those who take life calmly.

So if you have high blood pressure or even if you just want to be generally healthy, it makes sense to avoid getting wound up about everything, to take time to relax every day and to learn some practical skills for coping with situations you tend to come across which make you feel that you have no control over what happens to you.

It’s not easy to learn to relax without using some kind of technique no matter how much you tell yourself to calm down. But you can learn to relax by using a slow breathing technique, yoga or self hypnosis. It is well worth the effort.

Blood pressure does not always rise as you get older but it often does.

This may be due to the loss of elasticity in the arteries (often called hardening of the arteries) affecting the flow of blood – more pressure must be applied by the heart to drive the blood through the vessels when there is less elasticity to assist.

With atherosclerosis (roughening or “furring” of the artery walls) which is the most common cause of hardening of the arteries, there is a kind of vicious circle. High blood pressure makes atherosclerosis worse, and atherosclerosis in turn raises blood pressure.

A rise in blood pressure with age might also be due to putting on weight as we get older and being generally less active.

If you eat healthily, stay active, don’t smoke and keep your weight within the normal range, you are far less likely to suffer blood pressure problems as you get older.

High blood pressure in older people is generally treated by making lifestyle changes and using low dose medications if required. If you are overweight, one of the best things you can do for high pressure is to lose weight sensibly. Generally blood pressure reduces as weight falls.

The contraceptive pill and HRT (or hormone replacement therapy) both contain the hormone estrogen which may have an affect on your blood pressure.

Almost every woman who takes the pill experiences a slight rise in blood pressure and usually that is not too much of a problem. About 5% of women experience a more marked rise in blood pressure and if that is combined with other risk factors (such as a previous problem with high blood pressure, smoking, being over 35 or overweight) she might very well be advised by her doctor to stop taking it or to replace it with a low-estrogen or progesterone-only pill.

Normally blood pressure is monitored more regularly for women on the pill to catch any problems, but you should always contact your doctor immediately if you experience any worrying side effects. (For a list of symptoms to watch out for read the up-to-date instructions which comes with your particular pill).

Fortunately if blood pressure does rise, it is generally not a long term problem (at least as far as the pill is concerned). Once the pill is stopped it ceases to have an affect on blood pressure within a few weeks.

HRT (or hormone replacement therapy) is prescribed to help with the symptoms of the menopause which are caused by a reduction in estrogen production. Although it contains estrogen, HRT generally has less of the hormone than the contraceptive pill and therefore does not tend to affect blood pressure so much.

As long as blood pressure is checked regularly HRT has been found to be quite safe for most women as far as high blood pressure is concerned and your doctor will make sure that it is safe for you before prescribing it.

I have probably had high blood pressure for a long time. This is the story of how I found out.

In hindsight, I can identify many symptoms of high blood pressure, but I either ignored them or thought they were related to other things.

The major symptom I had was headaches. Most days I would either wake up with a headache or develop one. Some of them were real “”head splitters”" … occasionally I would have to lie down to stop the nausea. I remember often working in front of my computer and trying very hard not to move my head to avoid feeling sharp pains.

Since being diagnosed with high blood pressure and starting medication, I have not had one headache (around nine months now). My headaches were definitely due to my high blood pressure, but back then I thought they were due to stress, or poor posture due to sitting at a computer all day … or any number of things.

THE DIAGNOSIS

I had been told for years by doctors that my blood pressure was high, but that it was probably due to the “white coat” effect. Turns out it wasn’t. I went to a new doctor, and as she took my blood pressure, she had a very worried look on her face.

My systolic blood pressure reading was over 200.

She told me to go to hospital immediately and made me promise I would not ignore her warning. At the time I did think she was over-reacting, and I pictured myself sitting in the hospital emergency waiting room for a couple of hours, waiting for a doctor to see me, giving me a couple of pills to take, and heading home.

The actual story was very different.

I arrived at emergency and was given the standard “patient detail” form to fill out. Before I was 1/3 of the way through, a nurse turned up to take my blood pressure. She also got a worried look on her face, and took me straight to one of the emergency beds. This is in a hospital system famous for making people wait hours in emergency.

I had doctors all over me … injecting things, taking blood, scanning me and god knows what else.

My clearest memory of that day was suddenly feeling very light headed.

The doctor later told me that I “liked” a drug (I think it was hydralazine) he injected into me. I say “liked” because only a doctor could think I “liked” it. In about 30 seconds I went from feeling what I then considered normal, to being drenched in sweat, head spinning and throwing up my lunch. The nurses told me later that I was as white as a ghost.

I remember asking one of the emergency nurses if she thought I would be able to go home that night. She laughed.

I ended up spending 4 days in intensive care, and 6 days in the general hospital before they let me go home.

The quality of the care, the doctors and the nurses were all amazing. We have a free hospital system in Australia which sometimes gets a bad rap, but my experience was very positive.

MEDICATION

They never found a cause … I just have high blood pressure. I take a fair bit of medication, and my blood pressure is now at normal levels.

My doctor told me to buy a blood pressure monitor and record my readings each day. Because I kept forgetting to take my readings, I wrote a software program to remind me. The software also charts the readings from my home monitor, and it is clear that my readings have been dropping over the last six months.

My readings are now around 110-120 over 70-80. Much better, but more importantly, I feel a lot better … I had no idea that high blood pressure could make you feel so unwell.

If you also have high blood pressure I wish you well! If you have not seen a doctor about it, I highly recommend it … don’t leave it as late as I did, they can help you to feel a lot better!

Tai Chi can help patients suffering from high blood pressure due to the calming effect of the practice.

High Blood Pressure and Tai Chi Therapy
By Bill Douglas

Way back in 2003, the Journal of Alternative and Complimentary Medicine’s Oct. 9th issue reported a study finding that Tai Chi “could decrease blood pressure and results in favorable lipid profile changes and improve subjects’ anxiety status. Therefore, Tai Chi could be used as an alternative modality in treating patients with mild hypertension, with a promising economic effect.” This study laid out a way to save our society, perhaps billions of dollars annually, and possibly save some patients with mild chronic hypertension the potential negative side effects of chronic lifelong medication. However, this largely hasn’t occurred.

I caught a glimpse why when I was staying in the beautiful mountain town of Otavala, Ecuador, with a woman known for her knowledge of traditional Indian medicines. A tour of young American medical students stopped here to listen and learn from the Indian woman’s tour of her herbal gardens. As I followed them, I asked a group of young bright medical students if they were aware that Tai Chi was found to reduce high blood pressure. One lovely young woman replied, “Oh, yes, I’ve heard that, but I would never prescribe it.”

I asked why, and she responded that she couldn’t because she didn’t know if it would work. Although Tai Chi studies do show that Tai Chi indeed helps lower high blood pressure, it is true that it does not reduce it in every person. However, it is also true that every drug prescription does not work on every person either. I suggested to the young medical student that she consider that many times I’ve been to the doctor, and he’s pulled out a prescription pad and explained, “Let’s give this a try, and see how it works for you, and if it doesn’t do the job, we’ll try something else.” Most of us are familiar with this, and by the confused look on the student’s face, I’m assuming her memory banks were bringing up similar images.

So, why are our medical universities giving students the impression that they should not be prescribing Tai Chi, since we know it can help lower high blood pressure for many, who if it is successful with them, can enjoy a lifetime free of chronic and costly medications? And not only do that, but offer a plethora of GOOD SIDE EFFECTS including a stronger immune system and healthier respiratory system. This is a deep and important question we need to be asking as patients and consumers, and health professionals must begin asking this question regularly in order to fulfill the duties of their Hippocratic oath. For, today we have even a much better understanding of Tai Chi’s potential than we did a few years ago, so ignorance or inconclusive data is not an acceptable explanation from our medical universities that train our future doctors, without teaching them about Tai Chi research, and what it portends for their future patients.

Today, we are clearer on exactly why Tai Chi is such a powerful therapy for high blood pressure sufferers. In a March 17, 2005, article by the Mayo Clinic staff posted at mayoclinic.com they lay out what a “stress response” is, and the effects it has on the body. This is at the core of high blood pressure problems and the physical changes chronic stress responses illicit that creates or aggravates hypertensive conditions.

In their article, they explain that a stress response, or “fight or flight” reaction involves our pituitary gland releasing adrenocorticotropic hormone (ACTH), which sets a domino effect signaling other glands to produce additional hormones, such as adrenal glands which flood the blood stream with stress hormones, such as “cortisol” and “adrenaline.”

When ordinary life’s daily frustrations trigger this effect over and over again, the results can be damaging to the mind and body. Many of us experience this domino effect of triggers and hormones daily, which is why about 1/3 of Americans, or over 90 million Americans, suffer from high blood pressure.

Cutting edge scientists like Dr. Herbert Benson, President of the Mind/Body Institute at Beth Israel Deaconess Medical Center in Boston, are discovering a stunning reality through their research. In a wonderful article by Jeanie Lerche Davis at WebMD Medical News entitled The Mysterious ‘Medication’ of Meditation (http://my.webmd.com/content/article/25/1728_57992.htm), she writes of how such researchers are discovering that “meditation can indeed be medication – creating long lasting physiological effects that reduce high blood pressure and even help unclog arteries to reverse heart disease.”

Dr. Benson, who is also associate professor of medicine at Harvard Medical School, sought to prove how this effect could be shown objectively, and had five long-time meditation practitioners take MRI brain scans while meditating. Dr. Benson informed WebMD in the aforementioned article by Davis, “There was a striking quietude across the entire brain which was documented through MRI . . . The areas of the brain that became active from that quietude were those that control metabolism, heart rate, etc., . . . We knew meditation caused a relaxation response, but we couldn’t prove it. We knew that if you thought in a certain way, with repetition, that physiologic changes would occur in the body. Here now is proof that mind, in the form of repetition, is affecting the brain, which affects the body . . . ”

Stroke Magazine reported on a study funded by the National Institutes of Health, conducted by Dr. Amparo Castillo-Richmond, from the Maharishi University, more specifically on high blood pressure afflicting black people. The meditating group saw a reduction in the thickness of one of the arteries that supplied blood to the brain. Which indicates that blood flow is increasing. The group only using diet and exercise saw their artery walls getting thicker, which indicated that less blood was flowing through to the brain. This finding led Dr. Castillo-Richmond to make the profoundly exciting assertion, “It’s possible to reverse heart disease through meditation.” In fact, not only hypertension, but up to 90% of other illnesses sending us to the doctor are being caused by stress, according to Dr. Herbert Benson. Which makes Dr. Benson’s and Dr. Castillo-Richmond’s findings that meditative techniques can so dramatically alter our stress producing “fight or flight” response in healthy ways even more wonderful.

Dr. Benson explains, that the relaxation response triggered by repetitive forms [like tai chi, yoga, etc.] can result in decreased metabolism, heart rate, breathing rate, blood pressure, and also slower brain waves. Benson asserts that it is the repetitive nature of acts like praying the rosary, yoga, or tai chi’s physical repetitive muscular actions that provides the profound hope for reducing anxiety, mild and moderate depression, anger and hostility, hypertension, cardiac irregularities, and all forms of pain, which are made worse by stress.

This concept of Tai Chi being an effective tool for reducing or even avoiding incidence of high blood pressure or other illnesses all together, is echoed elsewhere. Mayoclinic.com also recommends Tai Chi for relaxation training in an article entitled, “Relax: Techniques to help you achieve tranquility” which also explains why relaxation is important and what you might experience by practicing tools that will help you relax.

They go on to explain that practicing relaxation techniques may help you experience: Fewer symptoms of illness, such as headaches, nausea, diarrhea and pain; Few emotional responses such as anger, crying, anxiety, apprehension and frustration; More energy; Improved concentration; Greater ability to handle problems; More efficiency in daily activities. So, time and time again as we begin to examine one particular benefit of Tai Chi, such as lowering high blood pressure, we see a whole universe of potential opening up before us.

An article from Archives of Internal Medicine, as reported on NBC’s local WCAU Health (http://wcau-tvhealth.ip2m.com/index.cfm?pt=itemDetail&Item_ID=112735&Site_Cat_ID=77) explained a Tai Chi research program at Tufts-New England Medical Center in Boston revealed a great deal. The article authors wrote, “Overall, these studies reported that long-term Tai Chi practice had favorable effects on the promotion of balance control, flexibility and cardiovascular fitness and reduced the risk of falls in elders . . . Cardiovascular and respiratory function improvements were noted in healthy people and those who had undergone coronary artery bypass surgery as well as people with heart failure, hypertension, acute myocardial infarction, arthritis and multiple sclerosis . . . Benefit was also found for balance, strength, and flexibility in older subjects; falls in frail elderly subjects; and pain, stress and anxiety in healthy subjects.” They add the actual ways that Tai Chi provides these benefits are not well known.

The fact is that less than .5% of the National Institute of Health’s budget goes to research alternative therapies, leaving yoga, meditation, tai chi, massage, herbal therapy, aroma therapy, and the entire massive field of alternative health systems to struggle over .5%, or a little over $100 million of the $28 billion (approx.) annual budget. Given the above studies, it boggles the mind that such a small portion of the health research dollars are going to Tai Chi.

To recap, about 1/3 of the American population suffers high blood pressure. Tai Chi is proven to be a beneficial therapy that not only has no bad side effects, but dramatically improves immune function, respiratory function, lowers the incidence of anxiety and depression, and profoundly improves the balance of practitioners. Tai Chi does more, but for our purposes here these profound realities are enough to show exactly why it is truly unbelievable that Tai Chi is getting so little scrutiny in medical research dollars, when it can save so many from chronic suffering and perhaps some from a lifetime of chronic costly medications.

It is time we all began to ask the question that all good consumers should ask, “What is the best way/product for my health?” If Tai Chi is that product, the next question is, “Why isn’t every physician offering it as an option to their patients with hypertension, as a prescription?” “Why aren’t all insurance policies covering such prescriptions for Tai Chi?” Ask and ye shall receive. We must become informed and demanding health consumers, in order to get the best health options available.

This article does not advocate self-treatment, and encourages all to make health choices in conjunction with their physician. However, if your physician is close-minded to anything but a certain group of health options, even when research indicates your choices may be wider, than it is time to have a good talk with your physician about possibly widening your options.

Copyright 2005 Bill Douglas

About The Author: Bill Douglas is the Tai Chi Expert at DrWeil.com, Founder of World T’ai Chi & Qigong Day (held in 50 nations each year), and has authored and co-authored several books including a #1 best selling Tai Chi book “The Complete Idiot’s Guide to T’ai Chi & Qigong.”

Doctors can prescribe a whole range of different medications which aim to reduce blood pressure. These are the kinds of drugs which you might be given.

Blood Pressure Medications: A Concise Guide
By Ray Kelly

High blood pressure is unfortunately something that most people have to deal with as they age. This is especially true for the average person in the western part of the world. The national average for high blood pressure is approximately 24% in the United States with most other Western countries within close proximity of that number.

Medication is the most frequent form of treatment outside of individual lifestyle choices. However, there are a wide variety of drug types used to treat high blood pressure and they each approach the problem in a unique fashion. A physician will prescribe the type of drug best suited for the needs of the individual patient.

DIURETICS

A diuretic is a medication that reduces the amount of water and sodium in the blood. The reduction in water helps to reduce the overall pressure on the walls of the blood vessels and as a result lower the overall blood pressure. A diuretic is usually prescribed in addition to another type of medication as opposed to being used a sole treatment by itself. Diuretics are often called “water pills” and the physician may refer to them as such.

BETA BLOCKERS

Beta blocks work to reduce the heart rate and lower the blood pressure by inhibiting the bodies “fight / flight” response. Essentially a beta-blocker blocks the ability of epinephrine and norepinephrine to stimulate the sympathetic nervous system. This action prevents the increased heart rate and high blood pressure, which is a direct result of that stimulation. The beta-blockers prescribed for high blood pressure have a calming effect and give the person a greater tolerance for stress.

ACE INHIBITORS

Angiotensin converting enzyme inhibitors, or ACE Inhibitors, as they are commonly known helped to reduce blood pressure by preventing the hormone Angiotensin II from forming. Angiontensin II normally constricts the blood vessels as well as acting on the brain to increase the need for salt and hydration.

ANGIOTENSIN ANTAGONIST

Angiontensin antagonists target the same hormone as ACE inhibitors, described above. However, rather than inhibiting the production of Angiotensin II it blocks its effect on the cells of the heart and blood vessels. These medications are also referred to as ARB’s, which stands for angiotensin receptor blockers. This is a newer type of medication which helps to modulate the renin-angiotensin system which has a big role in maintaining the bodies overall blood pressure and the volume of blood in the body.

CALCIUM CHANNEL BLOCKERS

This class of medications reduce the overall level of calcium in the heart which in turn reduces the blood pressure since the level of calcium dictates the force with which the heart pumps blood. Individuals with a weak heart (cardiomyopathy) are advised to not take a calcium channel blocker.

ALPHA BLOCKERS

Alpha-blockers bring blood pressure lower by limiting the nerve impulses sent to the blood vessels, which allows the blood to pass more freely. Whereas the beta-blockers affect the heart to decrease blood pressure, the Alpha-blockers affect the blood vessels.

ALPHA-BETA BLOCKERS

The Alpha-Beta class of drugs combines the effects of both the Alpha-blockers and the Beta-blockers, and thereby bring about lower blood pressure. See the descriptions for both to understand how they work.

NERVOUS SYSTEM INHIBITORS

Nervous system inhibitors work at the level of the brain as opposed to the circulatory system. Essentially this class of drugs reduces the nerve impulses sent the blood vessels thereby allowing them to be more relaxed which results in lower blood pressure.

VASODILATORS

A vasodilator works similar to many of the other drugs by relaxing the blood vessels and as a result lowering blood vessels. However, these medicines do not target the hormones or the heart directly. There are a large variety of these types of drugs and they act in different ways.

Eating celery regularly can control high blood pressure without the use of drugs according to China’s Hunan Hemotological Research Center.

Celery contains a naturally occurring chemical called “apigenin” which has been shown to dilate the blood vessels and contribute to preventing high blood pressure. Celery also contains very small amounts of a chemical in called 3-n-butylphtalide (3nb) which lowers blood pressure by relaxing the smooth muscles that line the blood vessels. 3nb also lowers the level of stress hormones called catacholamines.

In the Middle East, patients have routinely been given half a pound of celery a day to control hypertension. According to researchers at the University of Chicago, animals fed celery extracts had blood pressure readings 14 percent lower than those animals who did not receive the extracts. The animals were given the equivalent of 2 stalks daily. Systolic blood pressure readings went down an average of 15 points.

Compared to other vegetables, celery has a high natural sodium content so it can satisfy the craving for salt on low-salt diets. It also has a high potassium value. This makes it excellent for people who are taking hypertensive medications. Celery contains 341 milligrams potassium and 125 milligrams sodium per 100 gram serving. Any food with a ratio of at least three parts potassium to one part sodium is good for people with high blood pressure. In the body, the ratio between potassium and sodium is more than two to one. Most prepared foods, including cooked vegetables, reduce the ratio more than tenfold.

When the diet is high in salt sodium is retained in the cells with a large amount of water. An abundant amount of potassium is necessary to displace the accumulated sodium in the cells. If potassium is not present, the tissue cells retain water with the sodium. For this reason doctors prescribe diuretics, commonly called “water pills” in order to remove the water. When diuretics are taken to lower the blood pressure, they work by removing sodium from the body. But when sodium is removed, potassium is also removed. For this reason potassium supplements are usually prescribed in conjunction with the hypertension drug.

Celery contains a natural diuretic substance and has been used traditionally in treating obesity because it tends to eliminate water weight. But the balance between sodium and potassium is not unbalanced as it is when synthetic drugs are taken.

For people who have blood pressure which is only mildly or moderately high, the eating of celery may be all that is needed to lower it to normal levels. But even for those who have extremely high blood pressure readings, celery can be helpful. Celery is an excellent diuretic that can improve the effectiveness of high blood pressure medication, meaning that the dosage of medication may be reduced.

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